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Alvogyl and absorbable gelatin sponge as palatal wound dressings following epithelialized free gingival graft harvest: a randomized clinical trial

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Abstract

Objectives

This randomized controlled trial compares for the first time effects of Alvogyl versus absorbable gelatin sponge as palatal wound dressings on postoperative pain, amount of analgesic consumption, post-surgical bleeding, and wound re-epithelization.

Materials and methods

Following sample size calculation, 36 systemically healthy patients requiring palatal mucosal graft harvesting were randomized to receive Alvogyl (intervention group, 18 patients) or absorbable gelatin sponge (control group, 18 patients) palatal dressings. Patient-reported VAS pain scores over 2 weeks were defined as primary outcome. Post-surgical bleeding, number of analgesics consumed, and complete re-epithelialization of the palatal wound for up to 5 weeks were defined as secondary outcomes.

Results

Although significantly higher VAS pain scores were reported in the control as compared with the intervention group up to 12 days post-surgically (from (median [range]) 8.5 [2–10] to 1 [0–2] and from 6 [0–10] to 0 [0–2] respectively), with higher analgesics consumption (from 2 [1–3] to 1 [0–3] and from 1 [0–3] to 0 [0–2] tablets respectively), a multivariate regression analysis considering age, gender, graft width/length, tissue thickness, analgesics intake, and dressing type demonstrated no statistically significant effect of any factor, including dressing type on VAS pain scores. At 4 weeks, 22.2% of patients in the intervention group versus 11.1% in the control group demonstrated complete re-epithelization of their palatal engraftment site, before complete re-epithelization in both groups at 5 weeks. No post-surgical bleeding was reported with both dressings.

Conclusions

Within the study’s limitations, results suggest Alvogyl as a practical palatal surgical dressing, comparable with absorbable gelatin sponge in cost, pain reduction, hemostasis, and re-epithelization properties.

Trial registration

www.ClinicalTrials.gov Identifier: NCT03402321

Clinical relevance

Alvogyl could present a novel palatal wound dressing material, comparable with gelatin sponge.

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Acknowledgments

The authors thank Dr. Khaled Keraa for his excellent statistical analyses.

Funding

The work was supported by the Department of Oral Medicine and Periodontology, Faculty of Dentistry, Cairo University, Egypt.

Author information

Author notes

  1. Karim Ehab and Omneya Abouldahab contributed equally to this work.

Authors and Affiliations

  1. Private dental clinic, Fayyoum, Egypt

    Karim Ehab

  2. Oral Medicine and Periodontology Department, Faculty of Oral and Dental Medicine, Cairo University, Giza, Egypt

    Omneya Abouldahab & Karim M. Fawzy El-Sayed

  3. Periodontology Department, School of Dentistry, New Giza University, Giza, Egypt

    Abdallah Hassan

  4. Oral Medicine and Periodontology Faculty of Dentistry, Cairo University, Al Saraya Str. 11, Manial, Cairo, Egypt

    Karim M. Fawzy El-Sayed

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  1. Karim Ehab
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  2. Omneya Abouldahab
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  3. Abdallah Hassan
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  4. Karim M. Fawzy El-Sayed
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Contributions

Priv-Doz. Dr. Karim M. Fawzy El-Sayed: conceived and designed the idea of the experiment, conducted and supervised the conduction of the experiment, interpreting the results, and drafted and revised the manuscript; Dr. Karim Ehab and Dr. Abdallah Hassan: conducted the experiment and acquired the data; Prof. Omenya Abouldahab: interpreting the results and approved the final version of the manuscript.

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Correspondence to Karim M. Fawzy El-Sayed.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Ehab, K., Abouldahab, O., Hassan, A. et al. Alvogyl and absorbable gelatin sponge as palatal wound dressings following epithelialized free gingival graft harvest: a randomized clinical trial. Clin Oral Invest 24, 1517–1525 (2020). https://doi.org/10.1007/s00784-020-03254-z

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